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Years ago, surgical instruments were relatively simple tools, designed for cutting, spreading, chiseling and closing. Thankfully for most "consumers" of surgical services, those days are long past. Ralph Basile

The last 30 years have seen tremendous advances in the development of what are generically referred to as minimally invasive surgical devices. By making small incisions utilizing precise devices, the trauma to the patient is significantly reduced. This has meant safer surgical procedures that have patients in and out of healthcare facilities quicker (often in the same day). One of the key tools in aiding minimally invasive procedures have been endoscopic cameras and video display systems. With very precise tools, the surgeon requires very precise "vision." Endoscopic technology has delivered that.

As it seems with all new technologies, the "ray of sunshine" of this advanced technology has been accompanied with a dark cloud - these complicated medical devices are darn difficult to clean! Such devices often have internal channels not viewable to the naked eye. They have complicated hinge mechanisms that allow a wide range of motion, but also have multiple crevices, gaps, pulleys, gears, etc. that are not only complex, but tiny. New composite materials are joined with traditional stainless steel, or each other, to further complicate the task of cleaning. How are sterile processing professionals to cope?!

In recent years, products have come upon the market that are simple to use chemical reagent tests sensitive to key markers of organic soiling such as protein and hemoglobin. These tests have allowed rapid evaluation of the effectiveness of cleaning in ways not detectable by the naked eye. Sterile processing departments have also increased their use of lighted magnification with desktop style magnifiers that typically provide 1.75x magnification. Big, illuminated and convenient to use, these tools are a must in the modern CSSD.

Still, there are areas of instruments that have remained inaccessible to direct visual observation - lumens. Staring into the internal channel of a medical device is like staring into an unlit tunnel - often one that is just a few millimeters in diameter. What do you see? Darkness!

So the question had to be asked? Can the same kind of endoscopic camera technology the surgeon uses to perform minimally invasive surgery be harnessed to aid the sterile processing professional in evaluating the cleanliness and functionality of these delicate medical devices? And be within the budget of the typical sterile processing department? With recent developments in digital camera technology, the answer is yes.

If you have a "smart" mobile phone, then you have a digital camera in your pocket, backpack or purse. The camera sensor built into these phones provide high resolution images that are captured in a digital format readily displayed, saved and shared with others. This same technology is now being built into flexible scopes for inspecting the internal channels of medical devices. This approach to flexible scope design offers a number of advantages over traditional fiber optics.

First, and foremost, is an incredible improvement of the image quality. With fiber optics, as the number of glass fibers are reduced, the resolution or quality of the image is also reduced. In very small bundles, below 5mm in diameter, the image can be blurry. Conversely, with the use of modern digital camera technology, the optical imaging sensor is actually placed right at the tip of the scope, delivering a clear, well defined image.

Another issue often experienced with fiber optics, is their delicate nature. A fiber optic scope has thousands of individual strands of glass. These strands are very delicate and when flexed and bent, they easily break. Not so with modern digital camera technology. The only thing running through the shaft of these flexible inspection scopes are wires that relay the bits and bytes from the image sensor at the tip - and deliver the power to that image sensor as well as the LED light also located at the tip.

Power and lighting bring up another important advancement made possible by digital imaging technology - unlike with traditional fiber optic systems that require a separate light source and some kind of individually powered camera coupling mechanism - the digital imaging technology found in flexible inspection scopes, including the lighting, camera and image capturing system, are all powered by the USB port of a desktop or laptop computer.

Advancements in the design and function of surgical instruments have meant safer, more effective procedures with dramatically reduced recovery times for patients. These advancements also make possible the "visualization" and diagnosis of diseases in areas of the body therefore not observable. In the same way, recent advancements in digital camera technology are making possible the visual inspection of areas of medical devices that heretofore could not be observed.

We are indeed on a fantastic voyage into the future!

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